Abstract

In the revised IHS criteria published in 2004, the childhood periodic syndromes are considered as conditions that are commonly precursors of migraine. These include cyclical vomiting syndrome, abdominal migraine, and benign paro- xysmal vertigo of childhood. Cyclical vomiting syndrome is a disorder characterized by repeated episodes of nausea and vomiting that last for hours to days, separated by symptom-free periods of variable length. The protracted vomiting may lead to severe volume depletion and the need for intravenous therapy. Symptoms often begin in young children and typically stop spontaneously at puberty, although some adolescents are affected. Abdominal migraine affects up to 4 percent of school age children. It is characterized by recurrent episodes of abdominal pain, typically midline or poorly localized, dull and moderate to severe in intensity. Abdominal pain is associated with at least two additional features that may include anorexia, nausea, vomiting, and pallor. Benign paroxysmal vertigo of childhood is the most frequent cause of dizziness in children. Episodes are usually brief, lasting only a few minutes, but may cluster, with recurrence of attacks several times within a few hours. Affected patients may suddenly appear frightened or unable to walk and will hold on for support. Children may experience decreased alertness or loss of strength and usually accompanied by features common in migraine, including nausea, pallor, phonophobia, and photophobia. The disorder resolves spontaneously after several episodic attacks. However, typical migraine may develop in later life in some patients.